tbuckley/cabot-search huggingface dataset:
Endarterectomy for Asymptomatic Carotid Artery Stenosis
Authors: Mark R. Goldstein
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The authors of the ACAS<sup>1</sup>concluded that patients with asymptomatic carotid artery stenosis of 60% or more and who have an acceptable surgical risk will have a reduced 5-year risk of ipsilateral stroke if carotid endarterectomy is performed vs standard medical management. Standard medical management included risk factor modification and aspirin. It was assumed that surgery could be done with less than a 3% perioperative morbidity and mortality. However, several recent studies demonstrate that in individuals with carotid artery disease and/or coronary artery disease and moderately elevated low-density lipoprotein (LDL) cholesterol levels, aggressive LDL cholesterol lowering (ie, attempting to decrease LDL levels below 2.6 mmol/L [100 mg/dL]) with hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors can significantly decrease cardiovascular events<sup>2-5</sup>and overall mortality.<sup>4,5</sup> Carotid stenosis frequently indicates widespread vascular disease. Individuals with carotid stenosis commonly have coronary artery disease. It is believed that lowering LDL cholesterol can
OP0139 ASSESSMENT OF ULTRASOUND DEFINITIONS AND A SCORING SYSTEM FOR SALIVARY GLAND DISEASE IN PRIMARY SJÖGREN’S SYNDROME: AN OMERACT PATIENT RELIABILITY EXERCISE
Authors: Stephanie Finzel, Sandrine Jousse-Joulin, Annamaria Iagnocco, Esperanza Naredo, Alojzija Hocevar, Sarah Ohrndorf, Petra Hanova, Maria-Antonietta D’agostino, Felicie Costantino, Lene Terslev, Helen Keen, George Bruyn
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Salivary gland ultrasound (SGUS) may have the potential of facilitating diagnosis and therapy monitoring of salivary gland disease in patients with primary Sjögren's syndrome (pSS). The aim of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) US subgroup on SG is to validate US as an outcome measurement instrument in pSS. Following the OMERACT US stepwise validation approach, preliminary consensus definitions for elementary lesions based on a systematic literature review were developed and subsequently a scoring system has been agreed upon and tested through a web-based Delphi exercise. <h3>Objectives</h3> To assess the reliability of consensus based SGUS scoring system in patients with SS. <h3>Methods</h3> Nine sonographers conducted an US reliability exercise of the parotid and submandibular glands (PG, SMG) of 9 patients with primary and secondary SS in 3 rounds. A 4-grade semi-quantitative scoring was applied in B-mode for structural lesions as follows: Grade 0: normal, grade 1: mild inhomogeneity without anechoic or hypoechoic areas, grade 2: moderate inhomogeneity with focal anechoic or hypoechoic areas, grade 3: severe; diffuse inhomogeneity with an-/hypoechoic areas occupying all the surface of the gland. Next, presence or absence of typical pSS-lesions was scored in binary fashion. Intrareader and interreader reliability were computed by Cohen and Light kappa. Weighted k coefficients with absolute weighting were calculated for B-mode abnormalities. <h3>Results</h3> Light weighted kappa for grading and diagnostic evaluation for intra- and inter-reader reliability was moderate to excellent (see Table for details). <h3>Conclusion</h3> The developed US definitions and the scoring system for salivary gland lesions in pSS showed a good to excellent reliability in patients with SS. Next step is to apply the scoring system in clinical trials. <h3>Disclosure of Interests</h3> Stephanie Finzel: None declared, Sandrine Jousse-Joulin: None declared, Annamaria Iagnocco: None declared, Esperanza Naredo Consultant for: Abbvie, Speakers bureau: AbbVie, Roche, Bristol-Myers Squibb, Pfizer, UCB, Lilly, Novartis, Janssen, and Celgene GmbH, ALOJZIJA HOCEVAR: None declared, Sarah Ohrndorf: None declared, Petra Hanova: None declared, Maria-Antonietta d'Agostino: None declared, Felicie Costantino: None declared, Lene Terslev Speakers bureau: Speakers fee from : Roche, Novartis, Pfizer, MSD, BMS, Celgene, Helen Keen: None declared, George Bruyn : None declared
OP0145 NORMAL VERSUS ELEVATED ACUTE PHASE REACTANTS IN PATIENTS WITH POLYMYALGIA RHEUMATICA: ARE THESE DIFFERENT SUBSETS? 
Authors: Diane Marsman, Aatke van der Maas, Alfons den Broeder, Frank van den Hoogen, Nathan den Broeder, Nadine Boers
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Systemic signs of inflammation such as raised CRP or ESR are a classical feature of PMR, but some patients present with normal acute phase reactants (APR).<sup>1,2</sup> It is not known whether these patients represent milder forms of PMR, whether their disease is not yet fully expressed, or whether they represent another pathophysiological subset of PMR or another disease. Data on demographic and clinical differences between PMR patients with normal versus elevated APR might provide some answers. <h3>Objectives</h3> To explore baseline differences in demographics and clinical characteristics in PMR patients with and without elevated APR. <h3>Methods</h3> We conducted a retrospective cohort study of clinical characteristics of newly diagnosed PMR patients (clinical diagnosis) who visited our outpatient clinic between April 2012 and September 2017. Patient with concomitant inflammatory rheumatic disease were excluded. Data on patient-, disease,- and treatment characteristics were extracted from the electronic health record. Descriptive statistics were used [using mean (SD), median (p25-p75) or n (%) as appropriate], and differences between patients with high APR(CRP&gt;10 mg/L and/or ESR &gt;30mm/hour) were tested using Fischer's exact test for categorical data, t-test for normally and Wilcoxon test for non-normally distributed data. <h3>Results</h3> 454 patients were included (table 1). Sixty-two patients had normal, and 392 had elevated APR. In the group with normal APR, fewer patients had peripheral arthritis (2 versus 9%; p=0.044) and fewer had anemia at diagnosis (17 versus 43%; p= 0.001). Furthermore, patients had a longer median duration of symptoms before diagnosis (13 versus 10 weeks; p= 0.0196) and were more likely to have a history of PMR (16 versus 8%; p= 0.057). No significant differences were found in other clinical characteristics. <h3>Conclusion</h3> The results of this cohort indeed suggest that patients with normal APR are a different subset of PMR patients. Fewer cases have peripheral arthritis and anemia at diagnosis, suggesting a milder form of PMR. Secondly, our results do not support the hypothesis that PMR of those with normal APR is not yet fully expressed, as they have a longer symptom duration prior to diagnosis. <h3>References</h3> [1] Buttgereit F, Dejaco C, Matteson EL, Dasgupta B. Polymyalgia Rheumatica and Giant Cell Arteritis: A Systematic Review. JAMA. 2016 Jun;315:2442-58. [2] González-Gay MA1, Matteson EL2 Castaneda S3. Polymyalgia rheumatica. Lancet. 2017 Oct Oct 7;390(10103):1700-1712 <h3>Disclosure of Interests</h3> None declared
SAT0672 THE DIAGNOSTIC VALUE OF SERUM KL-6 IN CONNECTIVE TISSUE DISEASE ASSOCIATED INTERSTITIAL LUNG DISEASE
Authors: Xue Wu, Lijun Wu, Cai Nan Luo, Ya Mei Shi
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> The connective tissue diseases (CTDs) are a group of inflammatory, immune-mediated disorders. Involvement of the respiratory system, particularly interstitial lung disease (ILD), is common and is an important contributor to morbidity and mortality.Currently, high-resolution computed tomography (HRCT), bronchoscopic examination and surgical lung biopsy (SLB) are the basic methods for the diagnosis of ILD,But these tests require specific inspection machines,are less repeatable and cause considerable discomfort to the subject. <h3>Objectives:</h3> To evaluate the diagnosis of the serum Krebs von den Lungen-6 (KL-6)for the interstitial lung disease(ILD) associated with connective tissue diseases(CTD). <h3>Methods:</h3> Patients with CTDs who visited our Hospital between January, 2016 and December, 2017, and whose serum KL-6 level was measured were included. We analyzed 175 patients with CTDs,84 CTDs associated ILD,91 CTDs patients without ILD. Record age,gender,diagnosis,serum KL-6 levels,pulmonary function tests and performed in parallel were reviewed. Statistical analysis was performed using SPSS (version20.0) statistical package <h3>Results:</h3> The significantly higher levels of KL-6 were determined in the CTD-ILD group than in the CTDs without pulmonary involvement group(<i>P</i> &lt;0.05)( figure 1 ).By the ROC curves of serum KL-6 levels in 175 patients. The optimal cutoff value of serum KL-6 for a diagnosis of CTD-ILD was 409U/ml, and the sensitivity and specificity were82.1% and 86.8%, respectively. The AUC was 0.905(figure 2).Serum KL-6 correlated negatively with vital capacity(VC) (%predicted),forced vital capacity(FVC%)(%predicted),forced expiratory volume in one second(FEV1%)(%predicted) and diffusing capacity of the lung for carbon monoxide (DLcoSB) (% predicted) (Table 1). <h3>Conclusion:</h3> The serum KL-6 is a valuable biomarker for CTD-ILD diagnosis , and it is an important serum marker for detection of CTD-ILD activity. <h3>References</h3> [1] Capobianco,J, et al. Thoracic manifestations of collagen vascular diseases. Radio -graphics 32.1(2012):33-50. [2] Woodhead F, Wells A U, Desai S R. Pulmonary Complications of Connective Tissue Diseases[J]. Clinics in Chest Medicine, 2008, 29(29):149–164. [3] Kohno N, Kyoizumi S, Awaya Y, et al. New serum indicator of interstitial pneum -onitis activity. Sialylated carbohydrate antigen KL-6. Chest 1989; 96:68–73. [4] Ogz E O, Kucuksahin O, Turgay M, et al. Association of serum KL-6 levels with interstitial lung disease in patients with connective tissue disease: a cross-sectional study. Clinical Rheumatology, 2016, 35(3):663-666. <h3>Disclosure of Interests:</h3> None declared
AB0093 EFFECTIVENESS AND SAFETY OF PRILOCAINE IN COMBINATION WITH HYALURONIC ACID IN KNEE OSTEOARTHRITIS: AN OPEN-LABEL STUDY
Authors: Halil Koyuncu, ışıl Rendeci, Şafak Sahir Karamehmetoğlu
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Knee osteoarthritis (OA) is a degenerative progressive, debilitating and painful joint disease. Apart from surgery, treatment of OA includes pharmacotherapy and non-medical treatment such as physical therapy, exercise and local applications. Local hyaluronic acid, steroids and local anesthetics provide symptomatic relief and delay surgery. <h3>Objectives</h3> The present study aimed to assess the effectiveness and safety local prilocaine + hyaluronic acid combination in patients with painful knee osteoarthritis radiologically classified as having grade 2 and 3 OA. <h3>Methods</h3> A total of 64 patients with knee OA diagnosed as per the American College of Rheumatology (ACR) criteria were enrolled in the study. Of these patients, 42 had grade 2 and others had grade 3 disease. A single injection of the combination product was administered to all patients. The combination product contained 1 mg hyaluronic acid, 14 mg cross-linked hyaluronic acid, 6.9 mg sodium chloride and 3 mg prilocaine hydrochloride in a 2 ml solution. The combination was injected into a single joint in the painful knee through the anteromedial aspect of the joint. Assessments were performed before the treatment and at 4 and 12 weeks post-treatment by the same physician. The study was designed as an open-label, observational study. The patients were assessed using the Lysholm Knee Scoring Scale. Patient scores were categorized as poor (0-64), fair (65-83), good (84-90) or excellent (91-100). Pain and functional measures were evaluated by this scale. <h3>Results</h3> There was a female (n=58) predominance in the study sample. The mean age of the patients was 56.4 ± 15.3 years. As rated by the Lysholm Knee Scoring Scale, the number of patients with poor scores was 50 before treatment which decreased to 40 at 4 weeks and 30 at 12 weeks post-treatment. There were 4 patients which scored good before treatment and the number of patients with good scores rose to 6 at 4 weeks and 16 at 12 weeks. These findings were statistically significant (p&lt;0.05). None of the patients received any additional medication and all continued their daily activities. A home exercise program was followed by the patients throughout the study. Global evaluation of the study physician rated 40 patients in good or excellent condition, whereas 34 patients self-rated themselves in good or excellent condition. Six patients had local symptoms including swelling, pain and redness which were of mild-to-moderate intensity. These symptoms resolved in 1-3 days with simple interventions. <h3>Conclusion</h3> Local hyaluronic acid injections may represent an alternative to systemic medications in the treatment of knee osteoarthritis and they can provide long-term relief with minimal adverse effects when combined with local anesthetics without the need for additional drugs or treatments. <h3>Disclosure of Interests</h3> None declared
Combining Drugs Improved Hard-to-Treat Depression in Older Adults
Authors: Emily Harris
Journal: JAMA (2023)

Early Respiratory Infections Tied to Premature Death Later in LifeAfter adjusting for certain baseline factors, people who had lower respiratory tract infections such as bronchitis or pneumonia before age 2 years were almost twice as likely to die from a respiratory disease by age 73 years compared with those who were not infected as children.The majority of deaths from respiratory problems were due to chronic obstructive pulmonary disease, according to the results from 3589 UK participants included in the analysis.The researchers did not find a link between lower respiratory tract infections in childhood and higher risks of premature death from other causes.The link might be driven by factors such as maternal smoking that the researchers could not account for, the authors of an associated comment noted in The Lancet.Still, the study "adds to the evidence that adults whose chronic lung disease has been attributed to smoking-related effects might also have disease resulting from childhood exposures that are largely preventable," the comment's authors wrote.
Inflammation Genes Show Age-Dependent Link With Autism
Authors: Emily Harris
Journal: JAMA (2023)

Early Respiratory Infections Tied to Premature Death Later in LifeAfter adjusting for certain baseline factors, people who had lower respiratory tract infections such as bronchitis or pneumonia before age 2 years were almost twice as likely to die from a respiratory disease by age 73 years compared with those who were not infected as children.The majority of deaths from respiratory problems were due to chronic obstructive pulmonary disease, according to the results from 3589 UK participants included in the analysis.The researchers did not find a link between lower respiratory tract infections in childhood and higher risks of premature death from other causes.The link might be driven by factors such as maternal smoking that the researchers could not account for, the authors of an associated comment noted in The Lancet.Still, the study "adds to the evidence that adults whose chronic lung disease has been attributed to smoking-related effects might also have disease resulting from childhood exposures that are largely preventable," the comment's authors wrote.
Primitive Oligodendrocyte Precursor Cells Are Highly Susceptible to Gliomagenic Transformation
Authors: Daniel B. Zamler, Jian Hu
Journal: Cancer Research (2023)

Abstract Glioblastoma is the most deadly and common primary tumor of the central nervous system. Heterogeneity in the disease causes complications from diagnosis to treatment. It has long been suggested that a stem cell and/or progenitor population may be the origin of this disease and provide the underlying heterogeneity. However, which population precisely is the cell of origin, or whether there is only one cell of origin, has remained elusive. Previous studies have shown that, with proper combinations of oncogene expression and tumor suppressor loss, three cell types have the potential to transform into glioma—neural stem cells (NSC), oligodendrocyte precursor cells (OPC), and astrocytes. In a newly published article in Cancer Research, Verma and colleagues make a convincing argument through elegant animal work that an intermediate progenitor cell population, primitive OPCs, has higher tumorigenic potential than the NSCs or OPCs. This study helps rectify the controversy around which cell populations are the most sensitive to transformation in gliomagenesis. See related article by Verma et al., p. 890
<i>Mycobacterium</i> Infections Traced to Hospital’s Water Purification System
Authors: Emily Harris
Journal: JAMA (2023)

Early Respiratory Infections Tied to Premature Death Later in LifeAfter adjusting for certain baseline factors, people who had lower respiratory tract infections such as bronchitis or pneumonia before age 2 years were almost twice as likely to die from a respiratory disease by age 73 years compared with those who were not infected as children.The majority of deaths from respiratory problems were due to chronic obstructive pulmonary disease, according to the results from 3589 UK participants included in the analysis.The researchers did not find a link between lower respiratory tract infections in childhood and higher risks of premature death from other causes.The link might be driven by factors such as maternal smoking that the researchers could not account for, the authors of an associated comment noted in The Lancet.Still, the study "adds to the evidence that adults whose chronic lung disease has been attributed to smoking-related effects might also have disease resulting from childhood exposures that are largely preventable," the comment's authors wrote.
Gut microbiota: a non-target victim of pesticide-induced toxicity
Authors: Tusha Sharma, Nagabhishek Sirpu Natesh, Ramesh Pothuraju, Surinder K. Batra, Satyanarayana Rachagani
Journal: Gut Microbes (2023)

The human gut microbiota can be potentially disrupted due to exposure of various environmental contaminants, including pesticides. These contaminants enter into non-target species in multiple ways and cause potential health risks. The gut microbiota-derived metabolites have a significant role in maintaining the host's health by regulating metabolic homeostasis. An imbalance in this homeostasis can result in the development of various diseases and their pathogenesis. Pesticides have hazardous effects on the host's gut microbiota, which is evident in a few recent studies. Therefore, there is an urgent need to explore the effect of pesticide on gut microbiota-mediated metabolic changes in the host, which may provide a better understanding of pesticide-induced toxicity. The present review summarizes the pesticide-induced effects on gut microbiota, which in turn, induces changes in the release of their secondary metabolites that could lead to various host health effects.
Association of Area Deprivation With Primary Hypertension Diagnosis Among Youth Medicaid Recipients in Delaware
Authors: Carissa M. Baker-Smith, Wei Yang, Mary J. McDuffie, Erin P. Nescott, Bethany J. Wolf, Cathy H. Wu, Zugui Zhang, Robert E. Akins
Journal: JAMA Network Open (2023)

The association between degree of neighborhood deprivation and primary hypertension diagnosis in youth remains understudied.To assess the association between neighborhood measures of deprivation and primary hypertension diagnosis in youth.This cross-sectional study included 65 452 Delaware Medicaid-insured youths aged 8 to 18 years between January 1, 2014, and December 31, 2019. Residence was geocoded by national area deprivation index (ADI).Higher area deprivation.The main outcome was primary hypertension diagnosis based on International Classification of Diseases, Ninth Revision and Tenth Revision codes. Data were analyzed between September 1, 2021, and December 31, 2022.A total of 65 452 youths were included in the analysis, including 64 307 (98.3%) without a hypertension diagnosis (30 491 [47%] female and 33 813 [53%] male; mean [SD] age, 12.5 (3.1) years; 12 500 [19%] Hispanic, 25 473 [40%] non-Hispanic Black, 24 565 [38%] non-Hispanic White, and 1769 [3%] other race or ethnicity; 13 029 [20%] with obesity; and 31 548 [49%] with an ADI ≥50) and 1145 (1.7%) with a diagnosis of primary hypertension (mean [SD] age, 13.3 [2.8] years; 464 [41%] female and 681 [59%] male; 271 [24%] Hispanic, 460 [40%] non-Hispanic Black, 396 [35%] non-Hispanic White, and 18 [2%] of other race or ethnicity; 705 [62%] with obesity; and 614 [54%] with an ADI ≥50). The mean (SD) duration of full Medicaid benefit coverage was 61 (16) months for those with a diagnosis of primary hypertension and 46.0 (24.3) months for those without. By multivariable logistic regression, residence within communities with ADI greater than or equal to 50 was associated with 60% greater odds of a hypertension diagnosis (odds ratio [OR], 1.61; 95% CI 1.04-2.51). Older age (OR per year, 1.16; 95%, CI, 1.14-1.18), an obesity diagnosis (OR, 5.16; 95% CI, 4.54-5.85), and longer duration of full Medicaid benefit coverage (OR, 1.03; 95% CI, 1.03-1.04) were associated with greater odds of primary hypertension diagnosis, whereas female sex was associated with lower odds (OR, 0.68; 95%, 0.61-0.77). Model fit including a Medicaid-by-ADI interaction term was significant for the interaction and revealed slightly greater odds of hypertension diagnosis for youths with ADI less than 50 (OR, 1.03; 95% CI, 1.03-1.04) vs ADI ≥50 (OR, 1.02; 95% CI, 1.02-1.03). Race and ethnicity were not associated with primary hypertension diagnosis.In this cross-sectional study, higher childhood neighborhood ADI, obesity, age, sex, and duration of Medicaid benefit coverage were associated with a primary hypertension diagnosis in youth. Screening algorithms and national guidelines may consider the importance of ADI when assessing for the presence and prevalence of primary hypertension in youth.